Krishna, S., Boren, S. A., & Balas, E. A. (2009). Healthcare via cell phones: A systematic review. Telemedicine Journal and E-Health : The Official Journal of the American Telemedicine Association, 15(3), 231-240. doi:10.1089/tmj.2008.0099; 10.1089/tmj.2008.0099
262 million cell subscribers in USA - almost every household has at least one, regardless of socioeconomic status (cell-phone much less of a barrier re: SES than computer)
Systematic review only included studies that had a control group - final set included 20 RCTs and 5 controlled studies; over 38,000 participants from 1950 to May 2008.
All studies (25) used either voice or SMS services - 8 used internet in addition to sms. 2 used emails in addition to other communications. Most “pushed” messages individualized to the patient. Only 2 featured 2-way communication.
Measured either processes of care or outcomes of care. Processes of care defined as delivery of healthcare issues - e.g. studies reported that sms appointment reminder programs decreased missed appointment rates. Outcomes of care defined as changed behaviours, clinical improvement, social functioning
Changed behaviours - smoking cessation programs with sms personalized messages were generally very successful vs. control group. One program featured a Maori community who received personalized messages in both both English and Maori, and this group was 2 times more likely to report cessation at 6 weeks than control group. Significantly higher medication compliance rate in HIV patients with memory impairment with SMS reminders vs. control group. Significantly higher insulin adherence in type-1 diabetics with SMS reminders with goal-specific prompts.
Clinical improvement - improved medical outcomes in diabetes, asthma, hypertension, stress management and physical activity. One study looked at anxiety scores in a commuter group who was sent a multi-media message narrating relaxation techniques on a tropical beach. This group scored significantly less anxiety than both people who were exposed to commercial videos featuring new-age music and people with no intervention.
Across all studies in review, 61% showed improvement in outcomes measured
Krishna, S., Boren, S. A., & Balas, E. A. (2009). Healthcare via cell phones: A systematic review. Telemedicine Journal and E-Health : The Official Journal of the American Telemedicine Association, 15(3), 231-240. doi:10.1089/tmj.2008.0099; 10.1089/tmj.2008.0099